1) we are getting extremely encouraging data on transmission prevention. You would want more specifically designed studies (my understanding is that they are in process), but I feel extremely confident that it will be high enough to reach herd immunity (95% reduction in symptomatic infections. Before the second dose a 62%reduction in symptomatic infections).
2) a virus or a live vaccine will produce all of the intercellular processes of an mRNA vaccine plus a lot more and in a much less controlled manner (I.e. self replication). I would feel safer looking down the road taking the mRNA vaccine. It is not like we are devoid of examples of long term effects from viral infections, although coronaviruses and adenoviruses would admittedly be low on my list for long term concerns.
3) for people with weakened immune systems (in particular Due to HIV, it might not be the best alternative. For people on immunosuppressant medication probably safer than a live vaccine, but vaccines don’t work well on patients with immune compromise. This is one of the reasons to try to achieve herd immunity, so those folks can function freely in society.
4) the kind of long-term study you would want would make it impossible to combat any pandemic. Additionally, if this thought process applied across the board, it would render all medical research financially impossible—the study costs would expand enormously (they are already not cheap) and the delay for the payoff would increase equally..
5) our world is becoming increasingly pandemic-friendly with increasing population and travel. Coming up with strategies both for intervention and response before the next pandemic is something that needs to be part of the post-Morten for this one. MRNA vaccines make a lot of sense for pandemic response as they have the extremely quick turnaround time you need. A much better plan for testing and contact tracing is also needed.
6) hopefully the Oxford/AstraZeneca vaccine will be available here., Do you think people should take that one? I will say that efficacy both against symptomatic and asymptomatic infections(needed to produce true herd immunity) appears to be worse than the mRNA vaccines. Side effects in the short term certainly don’t appear better.
From a national perspective, this has cost an enormous number of life-years, and is on pace to cost a lot more, while I am not in favor of indefinite shutdowns or sacrificing the development of our children, getting vaccinated is quite a modest sacrifice to get us through this and protect the vulnerable.